METHODOLOGIES

Jill provides speech therapy services to families at her office in San Anselmo and at select private schools. She uses innovative, evidence based intervention strategies and is trained in the following specialized techniques:

PROMPT is an acronym for Prompts for Restructuring OralMuscular Phonetic Targets. The technique is a tactile-kinesthetic approach that uses touch cues to a patient’s articulators (jaw, tongue, lips) to manually guide them through a targeted word, phrase or sentence. The technique develops motor control and the development of proper oral muscular movements, while eliminating unnecessary muscle movements, such as jaw sliding and inadequate lip rounding. Therapists begin by helping patients produce certain phonemes. A phoneme is the smallest increment of sound in speech. For example, the “d” sound in the word dog is one phoneme, the “o” is another and the “g” is yet another. Each phoneme requires different muscle contractions/retractions and placement/movement of the jaw, lips, tongue, neck and chest to produce. All of these things have to happen with the proper timing and sequence to produce one phoneme correctly. The therapist attempts to “teach” the patient’s muscles to produce a phoneme correctly by stimulating all of these through touch. With the timing and movement of more than 100 muscles involved, you can see why the training is so intense. PROMPT therapy is appropriate for a wide range of patients with communication disorders. The most common patients have motor speech disorders, articulation problems or are non-verbal children. Many patients with aphasia, apraxia/dyspraxia, dysarthria, pervasive development disorders, cerebral palsy, acquired brain injuries and autism spectrum disorders have benefitted from PROMPT therapy. An evaluation by a PROMPT-trained speech therapist is the only way to find out if a patient is appropriate for the therapy.

Hanen Programs The Hanen Centre’s family-focused programs for parents are led by Hanen Certified speech-language pathologists (SLPs) who have received special training at a Hanen Workshop. Through the use of activities and group discussions, small groups of parents learn to create and take advantage of everyday opportunities to improve their child’s communication skills. All Hanen Programs® use a combination of group training sessions (where only parents and the SLP are present) and individual consultations with the SLP (in which the child is present). This provides a comprehensive and personalized learning experience for each family participating in the program. For parents whose child is experiencing a communication difficulty, Hanen’s specialized programs can provide them with the tools they need for helping their child reach his or her fullest communication potential. Hanen has developed programs for parents in three areas: Language Delays, Autism Spectrum Disorder, and Asperger Syndrome.

It Takes Two to Talk- The Hanen Program® for Children with Language Delays The It Takes Two to Talk Program was specifically designed for parents of children with language delays. In a comfortable small group setting, you’ll learn how you can build your child’s language skills naturally during everyday routines and activities.

More Than Words-The Hanen Program for Children with Autism Spectrum Disorder Created specifically for parents of children with Autism Spectrum Disorder, the More Than Words® Program provides you with practical strategies for addressing your child’s specific needs and building his communication and social skills during everyday routines and play.

Social Thinking’s three-part process of social thinking

1.Social thinking is our meaning maker. We observe and listen to interpret the perspectives of others.The first step to improving social thinking is to keenly observe the social world that surrounds us. A client of Michelle Garcia Winner, a 43-year-old engineer, found this step particularly valuable. He spent time learning how to observe people to be more aware of the social situations in which he was expected to socially relate to others. He had this to say about the experience: “Observing the social interactions of others is very helpful to me as I formulate how to interact myself. I’ve learned not everyone walks with their head down avoiding eye contact all of the time. I’ve learned when and how to smile. I’ve studied what makes a stranger seem approachable. In short, you have to know the rules of the game in order to play the game.”

2. When seeking to engage or simply share space with others, we use social thinking to adapt our social behaviors (social skills) effectively as a means to meet our social goals. To do this, we must learn strong self-awareness, self-monitoring, and self-control. We must learn how to adapt our physical posture depending on the context, how we use our eyes to better understand others and communicate, and tools for conversational language to relate to others.

3. Social thinking and social skills directly impact how others feel about us. This impacts how we are treated, how we feel about others, and ultimately – how we feel about ourselves! At the end of the day, our social experience is an emotional experience. The purpose of social thinking is to produce social behavior that gives others the emotional experience you intend to give. The Social Thinking Methodology teaches people to be more aware of their emotions and better predict and relate to the emotions of others.

Oral Placement Therapy is a speech therapy which utilizes a combination of: (1) auditory stimulation, (2) visual stimulation and (3) tactile stimulation to the mouth to improve speech clarity. OPT is an important addition to traditional speech treatment methods for clients with placement and movement deficits. It is a tactile-proprioceptive teaching technique which accompanies traditional therapy. Traditional therapy is primarily auditory and visual.Clients with motor and/or sensory impairments benefit from tactile and proprioceptive components because speech is a tactile-proprioceptive act. OPT is used to improve articulator awareness, placement (dissociation, grading, and direction of movement), stability, and muscle memory; all of these are necessary for the development of speech clarity.

The Kaufman Speech to Language Protocol (K-SLP) is a treatment approach for childhood apraxia of speech (CAS), other speech sound disorders, and expressive language challenges.

Full words are often difficult to master for children who struggle to speak. But often there is immediate capability to produce the shell, or an approximation of the words.

The child’s own approximation may be much lower than their true capability. We help children to simplify words at a higher motor-speech level than what they attempt, by assisting them to produce best word approximations toward target vocabulary to be moved into functional expressive language. We then refine each word toward perfection as we continue our therapy efforts. This is performed through using cues, fading cues, using powerful and strategic reinforcement (motor learning principles), errorless teaching (cueing before failure), gaining many responses within a session, and mixing in varying tasks to avoid over generalization. The K-SLP has evolved over the years, following the most current research in CAS, motor learning principles, neurological development, applied behavior analysis, acquired apraxia of speech, and in sensory integration and praxis skills.

The K-SLP focuses upon the child’s motor-speech skills, shaping the consonants, vowels and syllable shapes/ gestures from what they are capable of producing toward higher levels of motor-speech coordination, giving them a functional avenue by which to become an effective vocal communicator.

Dynamic Temporal and Tactile Cueing is a treatment approach for Childhood Apraxia of Speech, as well as other motor speech disorders. Using auditory, visual, and tactile cueing, the method incorporates principles of motor learning into speech practice and feedback and uses a specific hierarchy of temporal delay between stimulus and response (i.e., simultaneous production, immediate repetition, repetition after delay, etc.). The temporal relationship used with children is constantly changed, trial by trial, depending on the child's accuracy, in order to shape the movement, facilitate motor learning, and develop more automaticity.